DR. RANDALL G SULLIVAN (NPI# 1114942653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114942653 |
| Entity Type | Individual |
| Full Name | DR. RANDALL G SULLIVAN |
| Credential | M.D. |
| Practice Address |
601 W Leota St North Platte NE 69101-6525 |
| Mailing Address |
Po Box 6210 Farmington NM 87499-6210 |
| Practice Telephone | 3086967251 |
| Practice Fax Number | 3086967261 |
| Mailing Telephone | 5056092258 |
| Mailing Fax Number | 5056092259 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2018-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
17415 | NE | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NE | 10025598700 | 05 | |
| NE | 47066229013 | 05 | |
| RAILROAD MEDICARE | P00681749 | 01 |
| Street Address |
601 W LEOTA ST |
| City | NORTH PLATTE |
| State | NE |
| Zip Code | 69101-6525 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689672040 | Rick Allen Kukulka | Radiology | 601 W Leota St, North Platte, NE 69101-6525 | 2005-07-11 |
| 1669098687 | Jessie Rose Thorup | Physician Assistant | 601 W Leota St, North Platte, NE 69101-6525 | 2020-06-25 |
| 1447898408 | Shelby Rademacher | Nurse Practitioner | 601 W Leota St, North Platte, NE 69101-6525 | 2019-12-20 |
| 1952957102 | Cecelia Rae Opela-sierks | Nurse Practitioner | 601 W Leota St, North Platte, NE 69101-6525 | 2019-08-14 |
| 1295299204 | Alexander Donald Lucci | Nurse Anesthetist, Certified Registered | 601 W Leota St, North Platte, NE 69101-6525 | 2019-01-23 |
| 1679047708 | Marisa Adlesich | Physician Assistant | 601 W Leota St, North Platte, NE 69101-6525 | 2019-01-11 |
| 1689146128 | Jonathan Wade | Nurse Anesthetist, Certified Registered | 601 W Leota St, North Platte, NE 69101-6525 | 2018-12-21 |
| 1710452834 | Nicholas Singer | Nurse Anesthetist, Certified Registered | 601 W Leota St, North Platte, NE 69101-6525 | 2018-10-04 |
| 1932694346 | Elijah Samuel Vincent | Nurse Anesthetist, Certified Registered | 601 W Leota St, North Platte, NE 69101-6525 | 2018-06-27 |
| 1114418241 | Lisa Elizabeth Kopf | Physician Assistant | 601 W Leota St, North Platte, NE 69101-6525 | 2018-05-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972017523 | Rocky Mountain Holdings, LLC | Ambulance | 5570 E. Lee Bird Drive, Northe Platte, NE 69101 | 2017-11-18 |
| 1396297503 | Karen L Gutherless | Counselor | 401 W Walker Road, North Platte, NE 69101 | 2016-11-04 |
| 1992165898 | Laren Alden Roper Jr. | Occupational Therapist | 1115 S Cottonwood, Great Plains Sports and Therapy Center, North Platte, NE 69101 | 2016-03-04 |
| 1669733085 | Stephanie Lynn Marcy | Anesthesiology | 601 W Leota Street, Anes: Anesthesiology, North Platte, NE 69101 | 2012-06-01 |
| 1033480470 | Wb Counseling LLC | Counselor | 319 E. B St., North Platte, NE 69101 | 2012-01-17 |
| 1306114962 | Amy J Kloess | Occupational Therapist | 8165 North Twin Lakes Rd, North Platte, NE 69101 | 2011-12-09 |
| 1043442312 | Derek Walrod | Dentist | 1225 South Poplar, Suite 500, North Platte, NE 69101 | 2009-08-20 |
| 1033374525 | Millie Erickson | Urology | 611 W. Francis St., Suite 200, North Platte, NE 69101 | 2008-07-23 |
| 1952586331 | West Central District Health Department | Public Health or Welfare | 111 North Dewey Street, North Platte, NE 69101 | 2008-01-04 |
| 1558579698 | Piper Dental Clinic | Dentist | 1919 West A Street, North Platte, NE 69101 | 2007-05-21 |
| Find all providers in zip 69101 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669467346 | Stuart Bonau Mcconnell | Psychiatry & Neurology | 102 N Dewey St, North Platte, NE 69101-5438 | 2005-09-19 |
| 1982018396 | Hwan-shyr Alex Ding | Psychiatry & Neurology | 601 W Leota St, North Platte, NE 69101-6525 | 2014-06-13 |
| 1649611864 | Geetanjali Sahu | Psychiatry & Neurology | 601 W Leota St, North Platte, NE 69101 | 2013-07-16 |
| 1124279427 | Narayana Murty Koduri | Psychiatry & Neurology | 600 E Francis St, Suite 8, North Platte, NE 69101-6796 | 2008-10-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790320075 | Resolve Medical Billing | Psychiatry & Neurology | 5402 Northwest Dr, Omaha, NE 68104-2844 | 2019-11-11 |
| 1699255869 | Nicholas Williams | Psychiatry & Neurology | 7701 Mercy Road, Suite 601, Omaha, NE 68124 | 2018-08-17 |
| 1588158083 | Alexander Sasha Dragic | Psychiatry & Neurology | 7500 Mercy Rd Ste 601, Omaha, NE 68124-2319 | 2018-06-18 |
| 1770005613 | Larisa Akah Che | Psychiatry & Neurology | 7710 Mercy Road, Suite 202, Cu Department of Psychiatry, Omaha, NE 68124-2353 | 2017-07-12 |
| 1598286577 | Caitlyn Milone | Psychiatry & Neurology | 7710 Mercy Road, Suite 202- Cu Department of Psychiatry, Omaha, NE 68124-2353 | 2017-06-29 |
| 1700306339 | Cynthia Paul Md LLC | Psychiatry & Neurology | 900 S 74th Plz Ste 400, Omaha, NE 68114-4667 | 2017-06-24 |
| 1316493943 | Siva Sundeep Koppolu | Psychiatry & Neurology | 985582 Nebraska Medical Ctr Cu Dept of Psychiatry, Omaha, NE 68198-5582 | 2016-09-01 |
| 1164978136 | Erin Christine Ranum | Psychiatry & Neurology | 42nd & Dewey St, Omaha, NE 68198-1023 | 2016-08-30 |
| 1689053456 | Jennifer Inbarasu | Psychiatry & Neurology | 14092 Boys Town Hospital Rd, Boys Town, NE 68010 | 2015-05-26 |
| 1538574421 | Nicholas Paul Basalay | Psychiatry & Neurology | 985582 Nebraska Medical Ctr Dept Of, Omaha, NE 68198-5582 | 2014-06-30 |
| Find all providers with the same taxonomy | ||||
| City | NORTH PLATTE |
| Zip Code | 69101 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.